Endometriosis and the gift of motherhood

When my first period came at age 13, it involved blood clots and extreme pain. I didn’t know what to expect or what was considered “normal,” but thankfully, my mother did. She recognized that my symptoms were unusual and immediately took me to see my pediatrician. I was first prescribed birth control pills, which seemed to help initially, but when my period remained heavy and painful, I was put on a different birth control pill that enabled me to have my period only four times a year.
I thought my situation was normal – albeit uncomfortable and inconvenient. No one ever suggested that painful periods could be anything more than bad luck. I would hear women talk about menstrual cramping and see advertisements for medications to relieve menstrual symptoms … I just figured I had bad periods like so many other adolescent and adult women.
I believed that for years.
Finding answers to years of pain
Then, when I was 22, my cousin Emily was diagnosed with endometriosis. I had never heard of it. I figured it was something extreme because Emily’s symptoms were much more severe than mine. Emily’s mother, my aunt Mary Alice, knew enough about my symptoms that she thought I might have endometriosis as well, even though my symptoms were different than Emily’s.
Endometriosis is a chronic condition affecting an estimated 5.5 million women in North America — 30-40% of whom become infertile. It occurs when tissue similar to that which...

CONCLUSION: High-grade ACJ instability is a complex and significant injury of the shoulder girdle that can cause persistent pain and functional impairment. The state of the evidence regarding its optimal treatment is weak. Large-scale, prospective, randomized comparative studies are needed in order to define a clear standard of treatment.
PMID: 30892184 [PubMed - in process]

CONCLUSION: The reported results of treatments for plantar fasciitis and metatarsalgia are heterogeneous. The efficacy of the individual measures should be studied in randomized controlled trials.
PMID: 30892183 [PubMed - in process]

We describe the case of a 50-year old woman presenting to the emergency department with right lower abdominal pain. CT-scan showed an obstruction without clear underlying cause. The hypothesis of obstruction due to intestinal adhesions without strangulation was assumed and non-operative management lead to recovery and dismissal of the patient. However, she presented 3 weeks later with identical complaints, this time showing a terminal ileitis on CT-scan. Surprisingly, a toothpick perforating the terminal ileum was found during endoscopy and could by removed. A clinician should think of foreign body ingestion when patients ...

Authors: De Vloo C, Nevens F
Abstract
Pruritus is a common, troublesome symptom in patients with cholestatic liver diseases, especially frequent in intrahepatic cholestasis of pregnancy (ICP) and in primary biliary cholangitis (PBC). Cholestatic associated pruritus can have profound effects on the quality of life. The underlying mechanism is still poorly understood. Severe potential pruritogens have been discussed, such as bile salts, opioids, steroid and lysophosphatidic acid (LPA), but none of these are considered as key mediators. Because of this unraveling pathophysiology the treatment of hepatogenic pruritus o...

Authors: Komen N, Dewint P, Van den Broeck S, Pauli S, de Schepper H
Abstract
The field of rectal cancer treatment is a dynamic and changing field, due to better understanding of the pathology and new medical treatment options, but perhaps mostly due to innovations in the surgical approach. Surgery is the cornerstone for rectal cancer treatment. Currently, Total Mesorectal Excision is the gold standard. After evolution towards laparoscopic TME, improving technology has led to the development of platforms that allow transanal TME and robotic TME. In addition, local excision can be performed safer and more accurately...

CONCLUSION: For some patients with gastrointestinal symptoms and peripheral eosinophilia, a high suspicion of EG is necessary and multiple endoscopic examinations might be helpful in diagnosis of EG. Most patients with EG could achieve remission after with the treatment of steroid or dietary elimination therapy.
PMID: 30888747 [PubMed - in process]